Jennifer Lang Financial Services, LLC.​Smart Money StrategiesWisdom For the Life You Want

​Do you know the difference between a Medigap and a Medicare Advantage plan?

If you choose a Medicare Advantage plan, you select one of many available plans, and the Advantage plan becomes your insurer. The plan sets the rates, determines copays, and chooses doctors in the network. Most Advantage plans have built-in drug plans.

If you have an Advantage plan, you are ineligible for a Medigap plan. For some of Medicare age, however, the Medigap plan may be more beneficial.

Medigap plans are known as Medicare Supplement Insurance. When you choose Medicare A and Medicare B as your primary health insurance, the Medigap plan covers the gap between what Medicare pays and what you are responsible for paying.

With a Medigap plan, if Medicare approves a procedure, Medigap pays the difference. With an Advantage plan, your doctor in the Advantage network manages your care subject to the insurer agreeing to the procedure. With Medigap, if your doctor accepts Medicare, they also accept your Medigap plan. If your health conditions require a higher level of care, a Medigap plan may be your best alternative. Choosing the best Medigap plan depends on your current medical conditions, where you are located, and how much you want to pay.

​​If telemedicine, also called an e-visit, is not a regular part of your health care, it soon may be.
Telemedicine is a mobile application that lets you visit a physician using video chat. You can send photos of a rash or cut or describe your symptoms and often receive a diagnosis and prescription – all from your home or office.

This innovative approach offers several benefits that are causing more Americans to consider telemedicine when they need a doctor.

One of the top benefits is avoiding a room crowded with other sick people while you wait to see a doctor. Minimizing exposure to germ-infested areas could make telemedicine a top solution for reducing outbreaks. Other benefits include reducing co-pays and wait time, eliminating commutes, and improving access to health care. Reduced cost is also a perk. In one study presented in San Diego at the June 2018 AHIP expo, in-person visits cost an average of $114 while e-visits came in at $38.

Telemedicine pros and cons depend on particular circumstances, but an e-visit may be the answer for common symptoms like a cold, the flu, an insect bite, asthma, cellulitis, or a sprain. Additionally, consider how much e-visit benefits could mean to Americans in remote areas with limited access to hospitals and doctors.

Is this covered by insurance? Some insurers cover and even encourage e-visits. Your health insurance may recommend using Skype, Facetime, or your insurer’s portal to visit your health provider electronically from your home. Medicare’s website lists when it will reimburse for telemedicine. Private health providers may offer e-medicine access. Check with your insurance carrier to determine providers and co-pays if you choose to participate in e-medicine.

​From tele-psychiatry to tele-ophthalmology, both health care providers and consumers have discovered the benefits of tele-medicine. An e-visit may lower your co-pay and allow you to stay home when you are ill. Check with your health care professional to see if this option is right for you.

​Testicular cancer is the most common form of cancer in young men ages 15-35, and the incidence of occurrence has been increasing. The good news, though, is that mortality rates are improving, due to dramatic improvements in treatment.

Applying for Life Insurance This form of cancer is a bit more aggressive than a lot of the other types of cancer, and is largely dependent on the Staging of the cancer from the post-operative pathology report.

Stage I, is typically when the cancer is confined to the testes; Stage II indicates metastasis to local lymph nodes; and Stage III occurs with metastasis to remote lymph nodes or other organs.

The primary questions you will be asked with this type of history are:

Age at diagnosis and date treatment ended?

What was the specific type of testicular cancer?

Stage of the cancer and whether it was a seminoma or non-seminoma

How was it treated? (Typically, it’s with removal of the testes — an orchiectomy.)

Any metastasis or lymph node involvement?

Frequency of follow up with Dr and any tumor marker testing results?​

The good news is that with an In-Situ or Stage I cancer, we can typically get you an offer shortly after treatment is completed with a low table rating and/or short term flat extra. Most often, you’ll be looking at Standard rates, once you reach 5 to 7 years with no reoccurrence.

​How Can I Help You?

​Flexible Savings Accounts (FSAs) and Health Savings Accounts (HSAs) are both great vehicles to reduce your tax liability if you are enrolled in a High-Deductible Health Plan (HDHP).

The FSA: Employers establish FSAs so their employees can deposit money to cover the cost of visit copays, prescription copays, and other uncovered medical expenses. As an employee, you may take a tax deduction, depending on federal and state rules, equal to the amount spent on allowable medical expenses, which includes copays and some other uncovered medical expenses. Your employer or its FSA administrator will reimburse you for out-of-pocket medical or dental expenses based on the paperwork you submit.

The HSA: If you have a high-deductible Affordable Care Act or other high-deductible plan and your employer does not offer an FSA, the HSA may be right for you. The HSA works like the employee-sponsored FSA, but you must establish your plan through a bank or credit union that offers HSAs. Any amount you deposit is tax deductible up to certain limits.

Individuals and families are limited in the amounts they can contribute to an HSA. In 2018, the limit was $3,450 for individuals. For families in an HDHP family plan, the 2018 limit was $6,900. Contribution limits are increasing slightly in 2019. For an individual, the 2019 limit is $3,500 and the family plan’s new limit is $7,000. Maximum out-of-pocket expenses in 2018 were $6,650 for an individual plan and $13,300 for a family plan. Maximum out-of-pocket expenses allowable in 2019 will increase to $6,750 for an individual plan and $13,500 for a family plan.​With today’s hefty out-of-pocket costs, an HSA or FSA plan makes sense. However, keep in mind that the rules of many plans require you to use all the money you deposit or you will have to forfeit it. Although some plans provide a short year-end grace period, estimating your projected out-of-pocket medical expenses before funding your plan for the year can help you avoid forfeiting any of your deposit. Your health insurance agent can provide additional information or resources about these accounts.

​Temporary life situations sometimes require short-term medical insurance. You might be between jobs, a recent college graduate, newly divorced, or retired but not eligible for Medicare. Maybe you missed open enrollment for the Affordable Care Act (ACA) or you cannot afford ACA coverage because you do not qualify for subsidies.

A short-term medical insurance policy can help you bridge the gap between group or other health insurance on the one hand and Medicare or group health at your new job on the other.

What are the pros and cons?
Short-term health plans often take effect within 24 hours of application and premium payment. If you drop a short-term plan, it may impose no penalties and may refund the unused premium. Premiums may be lower than for ACA plans, and short-term plans may offer more doctor and hospital options.

However, if you have preexisting conditions, short-term plans either will not accept you or will accept you but exclude those preexisting conditions. Maternity care, preventive and mental health care, prescription drugs, and substance abuse are benefits that short-term plans may not cover. Additionally, you usually cannot renew your short-term policy but instead must buy a new one.

While it is easy to apply for short-term plans online, the plans vary widely. A licensed health insurance agent can help find the best plan for you, at no additional cost.

What changes are coming?
Previously, rules limited short-term medical insurance to three months. As of October 2018, new rules allow insurers to offer short-term policies of up to 364 days, and you can renew the same plan for up to three years.

However, in many cases, the individual mandate penalty (the fine paid if U.S. citizens don’t maintain health coverage that meets minimum standards) continues to apply until 2019 because these plans do not meet ACA minimal essential coverage.

​Still, short-term medical coverage may be just what you need to fill a short-term gap in health coverage. Contact your health insurance agent for more information.

​It’s a busy time of year. The holidays have rushed in and you’re probably swamped with shopping, decorating, parties, and visits from the in-laws. In the midst of year-end chaos, don’t miss an important deadline. Open Enrollment for 2019 coverage under the Affordable Care Act (ACA) ends on Saturday, December 15.

Have you signed up for a plan for next year? If not, contact your insurance provider right away to make sure you have coverage when the calendar flips to 2019. ACA coverage is provided through the Health Insurance Marketplace for those who don’t have health insurance through another source, such as an employer or Medicare. Cost for the insurance is based on your income.

Your insurance agent can walk you through the various options available and help you complete the necessary paperwork. To sign up for a plan, you’ll need information about the size of your household, basic contact information and social security numbers for those being covered, employer information, income amounts, and current policy numbers if you have 2018 coverage.

What happens if you miss the deadline? Certain individuals may qualify for a Special Enrollment Period. Others may be eligible for an extension. For example, those whose current plan was discontinued and those who have had certain life events, such as getting married, usually qualify for an extension. Additionally, some states offer state-based marketplaces that have deadlines later than December 15. Areas affected by hurricanes have also been given extensions.

​Contact your agent to determine if you qualify for any of these special circumstances and to get your coverage process underway.

​​As the cost of US medical care continues to climb, many Americans are traveling abroad for surgery. The Centers for Disease Control estimates approximately 750,000 Americans travel abroad each year for medical care, including heart surgery, dentistry, and cosmetic surgery. While surgical costs can be lower abroad, there are risks. These considerations can help you decide if medical tourism is right for you.
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Talk to your own health care provider about your plans. Your doctor may offer useful insights into the pros and cons and also can tell you if you should take any particular medical precautions, such as obtaining the appropriate vaccinations needed for the country you’re traveling to.

Ensure communication won’t be an issue; consider possible language barriers before you travel.

Thoroughly check out the credentials of the doctor abroad who will treat you and the surgical and aftercare facilities.

Take complete copies of your medical records with you and bring back your medical records from the overseas medical facility post-procedure.

Determine which US doctor will provide any needed aftercare; some physicians may refuse to treat you due to liability concerns.

Flying shortly after surgery can increase the risk of blood clots, so ask your home provider how long you should stay before returning home.

Buy a travel policy that includes medical tourism. Emergency evacuation/repatriation coverage can provide the broadest coverage and offer you great peace of mind.

With an EMR system, your health care provider can record patient information electronically rather than using the old-school method of pen and paper. The intent of EMR is to streamline and improve health care quality. Generally, it’s more secure than handwritten patient notes, as it’s stored remotely. Plus, it’s instantly accessible to health professionals during emergencies.

EMR ensures patient records are more comprehensive – and more legible. The technology is faster. Whether it uses voice recognition software or information is entered by the practitioner on a tablet, diagnosis and treatment time is cut considerably.

For example, consider a comatose patient found lying on the street. Through identification found on his or her person, including the individual’s name, address, and perhaps an insurance card, emergency personnel can tap into the person’s EMR and, if indicated, begin to treat the condition.
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Another example: your primary care physician can electronically forward a prescription to your pharmacy, so you may be able to pick up your prescription immediately without a long wait or expensive delivery costs.

The negatives? EMR systems remain prohibitively expensive for smaller medical practices. As well, there’s a steep learning curve when an EMR system is first implemented. Learning their way around it can take time many doctors don’t have.

Although EMR generally reduces the possibility of error, mistakes can-and do-occur. Hurried cutting and pasting can result in skipped or repeated information, leading to confusion and miscommunication.

​That said, the pros generally outweigh the cons and, in any case, EMR is here to stay in one form or another. Consider that not too far in the future, all your medical information may be contained on a chip embedded in your health card and easily accessible when needed.

​Decoding health insurance lingo isn’t always easy but with a little planning and preparation you will soon be speaking the same language as your agent.
​The first step is to understand the basic types of health care plans including:

HMO or Health Maintenance Organization. You select a primary care provider who coordinates care. Low co-payments are typical. Often the lowest cost option, HMOs only provide coverage for providers employed or contracted by the HMO.

Point of Service Plans or POS. POS plants are similar to an HMO except you act as your own coordinator for care options. Although a POS provides a greater degree of latitude in provider selection, the additional time requirements may add a layer of complexity.

Preferred Provider Organizations or PPO. PPOs are typically the most flexible care arrangements but cost varies according to whether the provider is “in-network” or “out of network”. Typically PPOs tend to be more expensive than HMO options.

Catastrophic Coverage. Often the least expensive form of insurance, many catastrophic plans require high deductibles and exclude office visits or other day-to day-medical care. The emphasis is on major medical coverage for illness or hospitalization.

Short-Term Insurance. A policy that typically is used for 30, 90 or 180 days of coverage or to bridge the gap between jobs, prior to qualifying for employment-sponsored benefits of other situations where regular insurance has lapsed for a brief period.

Health Savings Accounts, or HSAs. A relatively unknown type of plan that combines a high deductible with a special tax-exempt savings account to keep premiums low.

*Referring SafeMoney.com Advisor: Jennifer LangIf I could show you a way to stay in control of your money until you take your last breath, but instead of giving that money to the government, nursing home or hospital, you could keep that ​

money in the family for generations to come, at the very least wouldn’t you want to know how to do that?​Learn how to protect your money from unnecessary risks.